Helping families, parishes, and dioceses navigate fertility with faith. Name(Required) First Last Address(Required) City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Email(Required) Diocese(Required)AlbanyAlexandriaAllentownAltoona JohnstownAmarilloAnchorage -JuneauArlingtonAtlantaAustinBakerBaltimoreBaton RougeBeaumontBellevilleBiloxiBirminghamBismarckBoiseBostonBridgeportBrooklynBrownsvilleBuffaloBurlingtonCamdenCharlestonCharlotteCheyenneChicagoCincinnatiClevelandColorado SpringsColumbusCorpus ChristiCovingtonCrookstonDallasDavenportDenverDes MoinesDetroitDodge CityDubuqueDuluthEl PasoErieEvansvilleFairbanksFall RiverFargoFort WayneFort WorthFresnoGallupGaryGaylordGrand IslandGrand RapidsGreat FallsGreen BayGreensburgGuamHarrisburgHartfordHelenaHonoluluHouma-ThibideauxHoustonIndianapolisJacksonJefferson CityJolietKalamazooKansas City - KansasKansas City - St. JosephKnoxvilleLa CrosseLafayette - LALafayette - INLake CharlesLansingLaredoLas CrucesLas VegasLexingtonLincolnLittle RockLos AngelesLouisvilleLubbockMadisonManchesterMarquetteMemphisMetuchenMiamiMilwaukeeMobileMontereyNashvilleNew OrleansNew UlmNew YorkNewarkNorwichOaklandOgdensburgOklahoma CityOmahaOrangeOrlandoOwensboroPalm BeachPatersonPensacolaPeoriaPhiladelphiaPhoenixPittsburghPortland - MainePortland - OregonProvidencePuebloPuerto RicoRaleighRapid CityRenoRichmondRochesterRockfordRockville CentreSacramentoSaginawSalinaSalt Lake CitySan AngeloSan AntonioSan BernadinoSan DiegoSan FranciscoSan JoseSanta FeSanta RosaSavannahScrantonSeattleShrevportSioux CitySioux FallsSpokaneSpringfield - MissouriSpringfield - IllinoisSpringfield - MassachusettsSt AugustineSt CloudSt LouisSt PaulSt PetersburgSteubenvilleStocktonSuperiorSyracuseToledoTrentonTucsonTulsaTylerUS MilitaryVeniceVictoriaWashington DCWheeling CharlestonWichitaWilmingtonWinonaWorcesterYakimaYoungstownPromoter Points - Check Each Box That Applies10 - Points Bulletin Announcement (10 Points) 50 Points Send in a picture of what you did. Must include release form below. (50 points) Get a new professional to the join FABM directory. (50 points) Get a new professional to join the Allies for FSI directory. (50 points) Attend a CCL picnic or team meeting. (50 points) Send us a Right to Life Contacts you know! Get points per contact! (50 points) Picture Upload(Required) Drop files here or Select files Max. file size: 50 MB. Right to Life Contact(Required) First Last Email(Required) Phone75 Points Make a NFP Bulletin Board (75 points) - Take a picture of it and send it in for an additional 50 points! Select the option above for sending a picture! 100 Points Give a NFP presentation. (100 points) Represent CCL at a table at a conference. (100 points) Attend a CCL TC Chart Case Review meeting. (100 points) Meet with a Family Life Representative. (100 points) Send in a video (doesn't have to be edited) of what you did! Under 2 minutes please. Must include Video Release. (100 points) Upload your Video Here!(Required)Max. file size: 50 MB.200 Points Organize and hold a CCL picnic or team meeting. (200 points) Successfully recruit a promoter. (200 points) Attend a Promoter Training meeting. (200 points) 250 Points Meet and talk with local clergy about NFP. (250 Points) 300 Points Get a new donor at the Patron Level ($60 or higher) so they can receive Family Foundations Magazine. (300 Points) 500 Points Successfully recruit a Teaching Couple. (500 points) Download PeakDay and leave a Review on Google or Apple. (500 points) Tell Us What you Did, Who You Referred, Who You Talked To, What You Presented and More! Don't forget to check the point boxes above!(Required)Photograph & Video Release FormConsent(Required) I agree to the below Photograph & Video Release FormI hereby grant permission to Couple to Couple League International, Inc and their “Doing Business As” names current or future which includes but is not limited to: PeakDay and Fertility Science Institute, the rights of my image, in video or still, and of the likeness and sound of my voice as recorded on audio or video tape with or without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published, or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area. Photographic, audio or video recordings may be used for ANY USE which may include but is not limited to: Presentations; Courses; Online/Internet Videos; Media; News (Press); Advertisement for the finished product. By signing this release, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. This release applies to photographic, audio or video recordings collected as part of the sessions. By signing this release, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes. Name of Whom is Consenting(Required) First Last Email(Required) Signature(Required) By typing in your name, you have given your digital signature that you agree to the above contract.
